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326290
Utilization of segmentation tools for identifying medication related problems in Medicare beneficiaries


Tuesday, November 3, 2015

Yvonne Mai, PharmD, Thomas J Long School of Pharmacy and Health Sciences, University of the Pacific, Stockton, CA
Tamlyn Ige, University of the Pacific School of Pharmacy & Health Sciences, Stockton
Stephanie Kattoula, University of the Pacific School of Pharmacy & Health Sciences, Stockton, CA
Kristine Markham, University of the Pacific School of Pharmacy & Health Sciences, Stockton, CA
Utsav Patel, University of the Pacific School of Pharmacy & Health Sciences, Stockton, CA
Beth Simon, Ph.D., Division of Medicare Health Plans Operations, Centers for Medicare & Medicaid Services, San Francisco, CA
Frank Funderburk, Office of Communications, Centers for Medicare & Medicaid Services, Baltimore, MD
Cynthia Valle-Oseguera, PharmD, School of Pharmacy, University of the Pacific, Stockton, CA
Edward Rogan, Pharm.D., BCACP, Pharmacy Practice, University of the Pacific Thomas J. Long School of Pharmacy and Health Sciences, Stockton, CA
Suzanne M. Galal, PharmD, Department of Pharmacy Practice, School of Pharmacy and Health Sciences, University of the Pacific, Stockton, CA
Rajul A. Patel, PharmD, PhD, Department of Pharmacy Practice, University of the Pacific Thomas J. Long School of Pharmacy and Health Sciences, Stockton, CA
background: Nearly 85% of the 55 million Medicare beneficiaries are 65 years of age or older. Most seniors have a high medication burden, and therefore are at increased risk for Medication Related Problems (MRPs). Patient segmentation categorizes individuals into distinct groups. We sought to discover if there were any differences in MRP across beneficiary patient segments.

methods: Thirteen Mobile Health Clinics were held in Fall 2014. At each clinic, beneficiaries were provided healthcare screenings/services including Medication Therapy Management (MTM), a comprehensive medication evaluation. A structured interview was conducted during which sociodemographic, attitudinal, and health status data were collected. The presence and type of MRP(s) was also recorded. Collected data were used to populate three different segmentation algorithms.

results: A total of 731 individuals were provided MTM services, of which 696 (95.2%) comprised the study sample. A MRP(s) was identified in 421 (60.6%) study participants. Segmentation models differed in their ability to detect differences in specific types of MRPs (e.g., therapeutic duplication, cheaper therapeutic alternatives, etc.) that were identified. The data further revealed significant differences in self-reported health status data between segments in each analyzed model.

conclusions: Patient segmentation procedures may help better identify the types of MRP,  and perceived health state differences, that are likely to occur across segments. Armed with this knowledge, pharmacists and other clinicians may utilize this information to more effectively provide patient-centered care, and prevent the occurrence of MRPs.

Learning Areas:

Advocacy for health and health education
Chronic disease management and prevention
Provision of health care to the public

Learning Objectives:
Describe the use of patient segmentation models with regards to their ability to identify the occurrence of a medication related problem Evaluate the difference in different segmentation models with regards to their ability to identify different types of medication related problems Assess self-reported health status differences between different patient segments using three different segmentation models

Keyword(s): Medicare, Treatment Outcomes

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been involved in research directly related to Medicare beneficiaries for the last four years. I have been involved with over 15 different research projects that have been presented at National meetings and/or published in peer reviewed journals regard Medicare beneficiary drug therapy and economic outcomes. I also am a practicing pharmacist who routinely serves Medicare beneficiaries in my practice.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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